Drinking Water Security and Public Health Disease Surveillance

Cynthia Yund, PhD, Environmental Protection Agency, Office of Research and Development,

National Homeland Security Research Center


The US EPA has been working with water utilities and the health departments to develop, utilize, and evaluate a variety of public health surveillance data streams for use in a drinking water contamination warning system (CWS). This presentation discusses the interdependencies between these organizations for event detection. Implementation of a CWS involves close coordination and communication between the water utility and local health departments in terms of planning, surveillance trigger validation, and response.



As the lead federal agency ensuring water security, the United States Environmental Protection Agency has tested tools for the integration of public health data with water quality data. Prototype contamination warning systems use geo-spatial and temporal analysis of water quality and human healthcare-seeking data from a variety of sources. Data from utilities include spatial characteristics of the distribution system as well as near real time water analysis or grab sample data. Examples of public health data resources include Poison Control Center calls and hospital emergency department data. Symptoms related to ingestion, inhalation, and dermal exposure to contaminated water have been evaluated. Patient record data filters have been derived from these categories for extraction and routine monitoring of relevant records. Pilot projects have demonstrated the feasibility and benefit of routine data sharing between the water sector and public health. Several statistical methods, such as Bayesian Networks, have been employed to synthesize results from disparate data types and operational responses. Alert responses from such tools can provide the user with a measure of likelihood of occurrence of a water-borne disease outbreak. These programs aim to foster communication, identify an event, analyze threat credibility through trigger validation, reduce response time, and mitigate community health effects while avoiding the economic burden of widespread disease.


Learning Objectives

At the end of this session, attendees will be able to:

1.      Identify the role of the US EPA for water security.

2.      Describe approaches for the integration of public health surveillance data and water quality data for detection of a water-borne outbreak cause by a drinking water contamination incident.

3.      Characterize the data streams comprising a water contamination warning system.